Massage Business Blog

Insurance Billing for Massage Therapists: Resources for Credentialing and Billing In WA & OR

Getting in network with insurance companies and billing insurance can feel overwhelming. I hope these resources will help simplify the process for you a bit! I do offer one on one training sessions and small group classes as well if you decide that you need more help. Please feel free to email me with questions anytime at massagebusinesscoach@gmail.com.

Credentialing Information*This information is the latest that I have on where/what to send to insurance companies to get in network with them.

Step 1: Create your credentialing packetYou will need to create a credentialing packet to send to insurance companies.*Hand sign and date each document right before you send them

Send the client an insurance intake form to get the required information, along with the HIPAA agreement and financial agreements to sign. Get a credit card on file on or before their first visit.

Get the client’s member ID or claim number, full name, birth date, address, phone number, name of adjuster or insurance company, contact information for adjuster or insurance company, main complaint and date of accident (if applicable).

Verification Questions to ask the insurance company/adjuster:

Is the client covered for massage therapy by a licensed massage therapist?

If so do they need a prescription?

Do they need pre-authorization?

Do they have a deductible and has it been met (for health insurance)?

What is the patient financial responsibility ie. copay/coinsurance?

How many visits do they get per year and is it shared with other providers? How many have they used? (for health insurance)

What CPT/Diagnosis codes can you bill for, is there a limit on the number of units per visit? What is the rate of reimbursement for the CPT code(s)

What is the preferred way to bill the insurance company. *always get a name/ref number of the person you spoke to

*Record this information so that you know what the client is covered for, what their co-pay is etc… also let the client know.

*Record detailed SOAP notes with progress reports and a clear treatment plan after each client visit.

Step by step checklist: Billing with Office AllyOffice Ally is an online insurance billing platform that makes billing on behalf of your clients quick and easy!

Billing through PracticeMate:

Create an Office Ally and Practice Mate account (this is a process that will likely take more than one day)

Login to Office Ally and click on the link to go to Practice Mate

Click on the “claims/billing” tab

Click on the “Add a new claim” link then choose the “cms 1500 2/12 new” link

Use the grey box with ellipses to search for and auto fill client and insurance company info.

Complete the CMS 1500, refer to the sample guide I sent you via email if you need help

Choose “update” at the bottom the page when you are finished

You will see the claim at the top of your list of claims. Click the arrow under “submit” to submit electronically, or “print” if you plan to fax to mail the claim yourself.

Add a new patient in Practice Mate

Choose “manage patients” tab

Choose “add new patient”

Fill in client name, DOB, address, phone in the “patient data” tab

Click “insurance” tab and fill in insurance information

Choose “add patient” at the bottom of the page

Add a new insurance company in Practice Mate

You will do this from the claims section on the cms 1500 in the box where the payer goes:

Click on ellipses

A new box will open, in that box, click “add new”

Another new box will open, choose “browse”

Search for and add the insurance company there

Insurance Billing Tips

Bill insurance companies at least one time per week, Record billing date and amount billed

Follow up with insurance companies around 60 days after billing if you have not been paid, record every interaction with a name and reference number for the call

Record payments as you get them.

Don’t forget to check Office Ally weekly for repairable claims, and ASHlink and Availity for EOB’s.

Insurance Billing CompaniesIf you decide that you do want to bill insurance companies yourself, here is a list of reputable companies that might be able to take it off your plate:)

Julie Campbell, MBA,LMT OR#15892

Julie is the owner of Written on the Body Massage and Acupuncture Studio located in the beautiful city of Portland, OR. She started her business in 2010 and has enjoyed learning from her many successes, failures and challenges along the way. Julie has a passion for business and loves helping her fellow Massage Therapists build their dream practices. She currently shares her skills, experience and knowledge with fellow Massage Therapists through 1:1 coaching sessions and small group classes. Julie and is eager to help shape the future of our profession by empowering Massage Therapists in Portland, OR and all over the U.S.